Managed Care - July 2008 - (Page 49) just how successfully the product has been tailored to an age group, says Ward. “Tonik is innovative in the sense that you can apply online. In many cases, after successfully completing the application process, applicants will be able to log off their computers with their temporary member ID cards in hand,” says Ward. “If you’re logging onto the Tonik Web site, messaging is targeted to you, versus someone who just turned 40. The 40-year-old is probably paying more attention to the name of the carrier, looking for the stability of the Anthem Blue Cross & Blue Shield brand. Young people want things done quickly. They want a response now.” Eventually, though, Anthem is betting that the young invincible will also favorably note the Blues brand. “A rider with a supplemental premium. . . .” T hree changes in public policy would help to insure many now-uninsured young adults, according to the Commonwealth Fund study “Rite of Passage: Why Young Adults Become Uninsured and How New Polices Can Help, 2008 Update.” One is to expand Medicaid and SCHIP coverage beyond 18. The other would be to mandate that colleges and universities require that all full- and part-time students be covered. The institutions themselves should offer health plans. The other change involves adjustments that should occur in private health insurance. Here’s that section of the study: “Extend eligibility for dependents under private coverage beyond age 18 or 19. Private insurers and both public and private employers could be required to define dependent coverage as all unmarried dependents beyond age 18 or 19. . . . [M]any states have recently redefined the age at which a young adult is no longer a dependent — from age 25 in Colorado and New Mexico up to age 30 in New Jersey. Some private and public employers already provide such coverage voluntarily. Under the Federal Employees Health Benefits Program, federal employees and members of Congress now enjoy coverage for unmarried dependent children under age 22. Such an expanded benefit could either be structured as a rider with a supplemental premium or simply be extended to all policies and covered by the family premium. Even increasing the age to 23 could cover an estimated 1 million unmarried dependent young adults. If the benefit requirement were extended to family policies, the average premium for those plans would rise by about 3 to 5 percent.” Best approach Matthews, of the Council for Affordable Health Insurance, says that Anthem Blue Cross & Blue Shield takes the better of two possible approaches to covering young invincibles. One way is by mandate. However, once you create a mandate, you need to determine what happens to those who still don’t buy insurance. “If the penalty isn’t severe enough, they simply decide to take the risk and pay the penalty,” says Matthews. How do you sell something to people who aren’t really interested? “Almost all states require people to buy auto insurance,” says Matthews. “But in most states, the number of people without auto insurance is nearly as high as the number of people without health insurance. It is so bad that a lot of states require drivers to have uninsured-motorist protection even though everyone is required to have auto liability insurance.” The better approach, Matthews says, is health insurers creating more targeted options for specific populations. “This Tonik plan has actually done very, very well.” He agrees that the natural progression of a consumer could mean more market share for Anthem Blue Cross & Blue Shield in the future. “Most of the young invincibles are just starting out,” says Matthews. “They’re working in a restaurant or they’re doing something like that. But in the next two or three years they’re probably going to find themselves a job that pays health insurance. They get married. They go on their spouse’s plan. Then they start having kids and then they really want comprehensive coverage. So you want to get them into the market in an entry-level product. This is where the growth is.” MC What’s on your mind? Write to us at: MANAGED CARE • Letters 780 Township Line Road Yardley, PA 19067 Fax: (267) 685-2966 E-mail: editors_mail@managedcaremag.com Letters may be edited for space and/or clarity. JULY 2008 / MANAGED CARE 49
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